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1 This is a Sample version of the Inhaled Corticosteroid Questionnaire (ICQ) The full version of watermark.. the ICQ comes without sample The full complete ICQ Overview information 24 page version includes ICQ-LF & ICQ-SF Scoring/ Administration instructions Inhaled Corticosteroid Questionnaire Long Form (ICQ-LF) 57 item questionnaire. - Inhaled Corticosteroid Questionnaire Short Form (ICQ-SF) 15 item questionnaire. ICQ Clinical Validity Buy full version here - for $ 7.00 Clicking the above buy now button will take you to the PayPal payment service website in which you can pay via credit card or your optional PayPal account. Once you have paid for your item you will receive a direct link to download your full complete e-book instantly. You will also receive an with a link to download your e-book. Each purchased product you order is available to download for 24 hours from time of purchase. Should you have any problems or enquiries please contact - info@agedcaretests.com To see more assessments tests and scales go to -

2 A self-rating scale for patient-perceived side effects of inhaled corticosteroids Juliet M Foster* 1,2, Eric van Sonderen 3, Amanda J Lee 1, Robbert Sanderman 3, Antoon Dijkstra 4, Dirkje S Postma 4 and Thys van der Molen 1,2 Address: 1 Department of General Practice and Primary Care, University of Aberdeen, UK, 2 Department of General Practice, University Medical Center Groningen, University of Groningen, The Netherlands, 3 Northern Center for Healthcare Research, University Medical Center Groningen, University of Groningen, The Netherlands and 4 Department of Pulmonary Diseases, University Medical Center Groningen, University of Groningen, The Netherlands Juliet M Foster* - j.m.foster@med.umcg.nl; Eric van Sonderen - f.l.p.van.sonderen@med.umcg.nl; Amanda J Lee - A.J.Lee@abdn.ac.uk; Robbert Sanderman - r.sanderman@med.umcg.nl; Antoon Dijkstra - a.dijkstra@int.umcg.nl; Dirkje S Postma - d.s.postma@int.umcg.nl; Thys van der Molen - t.van.der.molen@med.umcg.nl * Corresponding author Published: 24 October 2006 Respiratory Research 2006, 7:131 doi: / Received: 20 July 2006 Accepted: 24 October 2006 Abstract Background: Patient-reported side effect questionnaires offer a simple method for the systematic measurement of drug-related side effects. In order to measure patients' inhaled corticosteroids (ICS) related side effect perceptions the 14-day retrospective Inhaled Corticosteroid Questionnaire (ICQ) was developed. In this research we aim to assess the construct validity and reliability of the ICQ and test its responsiveness to dose changes in adult asthma patients. Methods: In a cross-sectional study, current inhaler users with asthma completed the ICQ (27 with non ICS inhaler; 61 BDP equivalent daily ICS low dose 400 µg; 62 mid dose µg; and 105 with high dose >800 µg). We generated 3 construct validity hypotheses: 1) a hierarchical dose-response pattern for scoring of the individual items on the ICQ, and statistically significant differences in the scores of each of the 15 ICQ domains by ICS dose group 2) an association between ICS dose and ICQ scoring after adjusting for appropriate confounders in multiple regression; 3) greater convergence between local side effect domains than between systemic and local domains of the scale. Test-retest reliability was assessed on a randomly selected subgroup of patients (n = 73) who also completed the ICQ a second time after 7 days. In a separate longitudinal study, 61 patients with asthma completed the ICQ at baseline and after changing their daily ICS dose, at 2- and 6- months, in order to test the ICQ's responsiveness. Results: All three construct validity hypotheses were well supported: 1) a statistically significant difference existed in scores for 14 domains, the high ICS dose group scoring highest; 2) ICS dose independently predicted ICQ scoring after adjusting for confounders; 3) greater convergence existed between local ICQ domains than between local and systemic domains. The ICQ had good reproducibility: test-retest intraclass correlation coefficients were 0.69 for all but the 'Facial Oedema' domain. In the longitudinal study, ICQ scores for 'Voice Problems' changed significantly at 2- and 6-months from baseline and other ICQ domains displayed trends in scoring change accordant with dose modulation at 6-months. Conclusion: The ICQ has good dose-related discriminative properties, is valid, reliable, and shows potential responsiveness to ICS dose change. This is the end of the Sample ICQ clinical validity. Please return to page 1 to purchase complete version. Page 1 of 15 (page number not for citation purposes)

3 Inhaled CorticosteThis is the end of the Sample ICQ clinical valid ity. Please r etur n Scoring & administration to page 1 to purchase complete version.roid Questionnaire (ICQ) The Inhaled Corticosteroid Questionnaire (ICQ) comes in two forms ie. a 57 item questionnaire long form and a 15 item short form. This ICQ is a useful tool for measuring patients' perceptions of ICS associated side effects. The ICQ shows good reliability and validity in asthma patients and has good discriminative properties. Used for systematic measurement, this simple questionnaire may provide a greater understanding of the side effect perceptions of patients in clinical practice and clinical trials, and will yield useful new perspectives on the relationship between perceived side effect of ICS and adherence. The ICQ covers a range of patient-perceived side effects including voice, throat, skin and mood problems. The ICQ was scored on an item level from 0 (not at all) to 6 (a very great deal) other response options being: 1 (a very little), 2 (a little), 3 (a moderate amount), 4 (quite alot), 5 (a great deal). In order that domain scores with differing numbers of items could be compared, the 15 domain scores were transformed into a score out of 100 The total score of the ICQ (0 100) is the average of the 15 domain scores (sum the scores of 15 domains/15). The highest score represents the greatest side effect. To calculate a score for a subscale: Add up all the respondents answers for each of the questions listed for that subscale (this is the raw score) place it in the subscale equation

4 Inhaled Corticosteroid Questionnaire - Long Form (ICQ-LF) Scoring Table - Subscales Question Numbers Subscale Score Range Voice Problems (VP) 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 21, 22, 23, = 100% VP raw total 90 Oropharynx Problems (OP) 12, 13, 14, 15, 16, 17, 18, 19, = 100% OP raw total 54 Unpleasant Taste (UT) 28, 29, 30, 31, 37, 38, = 100% UT raw total 42 Skin Hair and Nails (SHN) 41, 42, 43, 44, 45, 49, = 100% SHN raw total 42

5 Inhaled Corticosteroid Questionnaire - Short Form (ICQ-SF) Scoring Table - Subscales Question Numbers Subscale Score Range Voice Problems (VP) 1, 6 = 100% VP raw total 6 Oropharynx Problems (OP) 2 6 = 100% Unpleasant Taste (UT) 5 6 = 100% Skin Hair and Nails (SHN) 9 6 = 100% OP raw total 6 UT raw total 6 SHN raw total 6 This is the end of the Sample ICQ scoring instructions. Please return to page 1 to purchase complete version.

6 Inhaled Corticosteroid Questionnaire (ICQ-LF) (ORIGINAL UK ENGLISH VERSION - SEPTEMBER 15, 2003) Patient ID Name:_ Date:_

7 How much have you been affected by the following side-effects related to the use of your inhaler/s during the last 14 days? Not at all A very little A little (Please circle one number on each line) A A very Quite a A great moderate great lot deal amount deal 1. Hoarseness of the voice? 2. A rough voice? 3. A noticeable change to your voice? 4. Your voice feeling similar to how your voice feels when recovering from the flu? 5. Your voice feeling like it had gone to the back of your throat? 6. Not being able to sing? 7. Loss of speech volume so that you couldn t talk as loudly as normal? 8. A feeling of exhaustion when talking? 9. A painful throat when talking? 10. A feeling that other people couldn t understand your speech because you speak too softly or not clearly enough? This is the end of the Sample ICQ-LF questionnaire. Please return to page 1 to purchase complete version.

8 Inhaled Corticosteroid Questionnaire (ICQ-SF) (ORIGINAL UK ENGLISH VERSION - SEPTEMBER 15, 2003) Patient ID Name: Date:

9 During the last 2 weeks how much have you been affected by the following side-effects of your regularly inhaled medication? (Please circle one number on each line) Not at all A very little A little A moderate amount Quite a lot A great deal A very great deal 1. Hoarseness of the voice? 2. A need to clear your throat? 3. An itchy feeling in the back of your throat. 4. Oral thrush (sore throat covered with pustules, and difficulty swallowing)? This is the end of the Sample ICQ-SF questionnaire. Please return to page 1 to purchase complete version.